The leg

• Tibiofibular joints (gliding movements)

  Proximal tibiofibular joint (synovial)

  Distal/Inferior tibiofibular joint (syndesmosis/fibrous)
• Bones of ankle and foot

  7 tarsals (superior to red line)

  5 metatarsals

  14 phalanges
• Tibial nerve supply (posterior)

  Gastrocnemius

  Popliteus

  Plantaris

  Soleus

  Tibialis posterior

  Flexor digitorum longus

  Flexor hallucis longus

  Knee flexors, plantarflexors, & toe flexors
• Superficial fibular nerve (lateral)

  Fibularis longus

  Fibularis brevis

  Ankle evertors & weak plantarflexors
• Deep fibular nerve (anterior)

  Tibialis anterior

  Extensor hallucis longus

  Extensor digitorum longus

  Fibularis tertius

  Toe extensors ankle dorsiflexors & inverters
• Gastrocnemius - attachments

  Proximal:

  Lateral head: lateral condyle of femur

  Medial head: posterior surface of femur, superior to medial condyle Distal: calcaneal tendon – posterior surface of calcaneus
• Gastrocnemius - action

  knee flexion and ankle plantarflexion
• Gastrocnemius - NS

  tibial nerve
• Soleus - attachments

  P: posterior aspect of head of fibula, soleal line, and middle 1/3 of medial border of tibia

  D: calcaneal tendon – posterior surface of calcaneus
• Soleus - action

  ankle plantarflexion
• Soleus - NS

  tibial nerve
• Plantaris - action

  weak plantarflexor
• Plantaris - NS

  tibial nerve
• Popliteus - attachments

  P: lateral condyle of femur

  D: posterior surface of tibia, superior to soleal line
• Popliteus - action

  “unlocks knee” through rotation, weak flexor.
• Popliteus - NS

  tibial nerve
• Tibialis posterior - attachments

  P: interosseous membrane (IOM), posterior surface of tibia and fibula

  D: tuberosity of navicular and across the plantar surface of the foot (cuneiform, cuboid, calcaneum) to the base of 2nd‐4th metatarsals
• Tibialis posterior - action

  ankle plantarflexion and inversion
• Tibialis posterior - NS

  tibial nerve
• Flexor digitorum longus - attachments

  P: medial posterior surface of tibia

  D: plantar surface of distal phalanges of lateral 4 digits
• Flexor digitorum longus - action

  flexion of lateral 4 toes and ankle plantarflexion
• Flexor digitorum longus - NS

  tibial nerve
• Flexor hallucis longus - attachments

  P: posterior surface of fibula and inferior IOM

  D: plantar surface distal phalanx of hallux (big toe)
• Flexor hallucis longus - action

  flexion of hallux, weak ankle plantarflexion
• Flexor hallucis longus - NS

  tibial nerve
• Flexor retinaculum

  Pulley system for inversion

  Keeps tendons flat to body
• Fibularis longus - attachments

  P: head and superior 2/3 of lateral surface of fibula

  D: plantar surface of base of 1st metatarsal and medial cuneiform
• Fibularis longus - action

  ankle eversion and plantarflexion
• Fibularis longus - NS

  superficial fibular nerve
• Fibular brevis - attachments

  P: inferior 2/3 of lateral surface of fibula

  D: lateral surface of base of 5th metatarsal
• Fibular brevis - action

  ankle eversion and plantarflexion
• Fibular brevis - NS

  superficial fibular nerve
• Tibialis anterior - attachments

  P: lateral condyle and superior half of lateral surface of tibia and interosseous membrane (IOM)

  D: medial and plantar surface of medial cuneiform and base of 1st metatarsal
• Tibialis anterior - action

  ankle dorsiflexion and inversion
• Tibialis anterior - NS

  deep fibular nerve
• Extensor hallucis longus - attachments

  P: middle part of anterior surface of fibula and IOM

  D: dorsum of distal phalanx of hallux
• Extensor hallucis longus - action

  ankle dorsiflexion and hallux extension
• Extensor digitorium longus - attachments

  P: lateral condyle of tibia, superior surface of fibula and IOM

  D: dorsum of middle and distal phalanges 2‐5
• Extensor digitorium longus - action

  ankle dorsiflexion and extension of digits 2‐5
• Extensor digitorium longus - NS

  deep fibular nerve